Taussig-Bing anomaly is infrequently associated with interrupted aortic arch and size discrepancy of great arteries makes it difficult to undergo arch recons- truction and arterial switch operation. A 20-day old male infant was admitted with the diagnosis of Taussig-Bing anomaly with type B interrupted aortic arch. Multi-organ failure, due to the diminution of ductal flow, was stabilized after 3 weeks of prostaglandin E1 and controlled ventilatory support. The surgical correction consisted of VSD closure, arterial swtich and extended aortic arch reconstruction. The marked disparity between the hypoplastic ascending aorta and the dilated main pulmonary artery was overcome by constructing distal neoaorta using both native ascending and descending aortic tissue. The patient was extubated on postoperative 2nd day. Postoperative catheterization showed no left ventricular outflow obstruction, no intracardiac shunt, and no incompetence of neoaortic valve.
Alprostadil ; Aorta ; Aorta, Thoracic* ; Arteries ; Catheterization ; Catheters ; Diagnosis ; Double Outlet Right Ventricle* ; Humans ; Infant ; Male ; Pulmonary Artery ; Ventricular Outflow Obstruction

Addisons disease is relatively rare than secondary adrenal insufficiency and result from progressive adrenocortical destruction. The common causes are idiopathic autoimmune atrophy and tuberculosis of adrenal glands. It is generally regarded as incurable in the sense that substitution therapy is required for the rest of the patients life. We report a case of tuberculous primary adrenal insufficiency which was confirmed by biopsy. This case was treated with antituberculous medication and showen to have improved adrenocortical function after six months.
Addison Disease* ; Adrenal Glands ; Adrenal Insufficiency ; Atrophy ; Biopsy ; Humans ; Tuberculosis

BACKGROUND: Residual pleural thickening is frequently seen following treatment for tuberculous pleurisy, and pleural decortication is performend occasionally in patients with severe residual pleural thickening. However, predictive factors for the development of residual pleural thickening are uncertain at the initial diagnosis of the tuberculous pleurisy. Therefore, the purpose of this study was to identify the associated factors for residual pleural thickening at initial diagnosis. METHODS: We separated 63 patients diagnosed as tuberculous pleurisy into two groups; group 1 consisted of patients without residual pleural thickening and group 2 comprised patients with residual pleural thickening at the end of tuberculous pleurisy treatment. We analyzed the clinical characteristics, radiological findings, pleural biopsy and characteristics of pleural fluid between group 1 and group 2. RESULTS: The study population and clinical symptoms of the two groups were not significantly different and the duration of symptoms before treatment and the peripheral WBC were similar between the two groups. The presence of pulmonary tuberculosis, pleural fluid loculation or the amount of pleural effusion sid not differ significantly between the thwo groups. The incidence of positive AFB staining(group 1 : 8%, group 2 : 38%) and granuloma(group 1 : 30%, group 2 : 62%) on pleural biopsy specimens was significantly higher in group 2 than in group 1. Pleural fluid WBC and differential count, adenosine deaminase level, pH, preotein level or glucose level did not differ between the two groups. However, group 2 had higher LDH levels (1370±208mg/dl) than group 1 (860±71mg/dl, p<0.05). CONCLUSION: In tuberculous pleurisy, patients with residual pleural thickening following treatment demonstrated a higher incidence of posivive AFB staining and granuloma on the pleural biopsy specimens or higher LDH level in the pleural fluid than patients wihtout residual pleural thickening From these results, we speculate that the amonut of tuberculous bacilli and granuloma are probably correlated with residual pleural thickening in the tuberculous pleurisy.
Adenosine Deaminase ; Biopsy ; Diagnosis ; Drug Therapy* ; Glucose ; Granuloma ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Pleural Effusion ; Pleurisy* ; Sudden Infant Death ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary

Choridal osteomas are benign, ossified peripapillary lesions occurring predominantly in healthy young women, They appear as yellow-white to yellow-red lesions with well-defined geographics borders. On radiologic examination, bony lesion is shown. We report herein a case of choroidal osteoma located at the posterior pole of the left eye in a 27-years-old woman the chief complaint of decreased visual acuity.
Choroid* ; Female ; Humans ; Osteoma* ; Visual Acuity

Preretinal hemorrhage, which is located between the retina and vitreous face and is commonly developed on the macula, causes impaired central vision and if it persists, it may cause complications, such as epimacular membrane. A 49-year-old male who had dry type of age-related macular degeneration in both eyes and had an oval shaped premacular hemorrhage of unknown etiology in his left eye. We applied Q-switched Nd:YAG laser on membrane anterior to preretinal hemorrhage and ruptured it. Preretinal hemorrage was drained to inferior vitreous cavity and his central vision was rapidly improved.
Hemorrhage* ; Humans ; Macular Degeneration ; Male ; Membranes ; Middle Aged ; Punctures* ; Retina

In spite of large volume of reports, surprisingly little information is avail-able about the function of the foot in standing and there are still many controversies about the exact proportion of the weight distributed in discrete areas of the foot. The purpose of this study is to evaluate about the exact proportion of the weight distribution in discrete areas of the foot through the photoelastic technique. In the results of this study according to the 10 regional division method, 4.4% of the total load of one foot was loaded on the toes(1 st toe, 2.2% ;2nd toe, 0.8%; lateral toes, 1.4%), 27.4% on the metatarsal area(lst metatarsal, 6.6%; 2nd metatarsal 8.7% ; lateral metatarsals, 12.5%), 8.6% on the midfoot(medial midfoot, 1.4%; lateral midfoot, 7.3%) and 59.2% on the heel(medial heel, 31.9%; lateral heel, 27.%), respectively. As in other reports, the toes played little role in weight bearing and the midfoot suggested the presence of the longitudinal arch. The metatarsal area received considerable amount of weight but the priority of the first metatarsal area was not demonstrable, rendering the presence of the transverse metatarsal arch doubtful. The heel received more than half of total weight given in one foot(p < 0.005). No significant difference was demonstrable between the dominant side and the nondominant side other than in midfoot.
Foot ; Heel ; Metatarsal Bones ; Methods ; Toes ; Weight-Bearing

PURPOSE: Lactobacillus casei (L. casei) is known to exert anti-proliferation effects on many types of cancer cells. However, the effect of L. casei on liver cancer has not been reported. Accordingly, the aim of this study was to determine the anti-cancer effect of L. casei extract on Huh7 cells. MATERIALS AND METHODS: L. casei ATCC393 extract was prepared and purified. After the treatment of L. casei extract on Huh7 cells, cell viability, cell cycle arrest and cell death were analyzed by flow cytometry. The expression levels of tumor necrosis factor-alpha receptor 1 (TNFR1) and death receptor 3 (DR3) mRNA related with extrinsic apoptosis were assessed by reverse transcription polymerase chain reaction. Additionally, P21 and P27 cell cycle proteins as well as Caspase-3, -8, -9, phospho-Bad and Bcl-2 apoptosis proteins were analyzed by western blot analysis. To determine the effect of L. casei extract on cancer stem-like cells, we analyzed changes in side population fraction through flow cytometry. RESULTS: The cell viability of Huh7 cells treated with L. casei extract was decreased by 77%, potentially owing to increases in the rates of Huh7 cells arrested in the G2/M phase (3% increase) and that underwent apoptosis (6% increase). The expression levels of TNFR1 and DR3 mRNA, as well as P21 and P27 cell cycle proteins, were increased. Meanwhile, the expressions of caspase-8, -9, phospho-Bad and Bcl-2 proteins decreased. However, in the case of side population cells, no remarkable changes were observed. CONCLUSION: L. casei extract exerts a potent anti-tumor effect on the viability of liver cancer cells, although not on cancer stem-like cells.
Apoptosis/drug effects ; Carcinoma, Hepatocellular/*pathology ; Caspase 8/metabolism ; Caspase 9/metabolism ; Cell Cycle Checkpoints/drug effects ; Cell Extracts/*pharmacology ; Cell Line, Tumor ; Cell Proliferation/drug effects ; Cyclin-Dependent Kinase Inhibitor p21/metabolism ; Cyclin-Dependent Kinase Inhibitor p27/metabolism ; Cytostatic Agents/*pharmacology ; Flow Cytometry ; Gene Expression Regulation, Neoplastic/drug effects ; Humans ; Lactobacillus casei/*chemistry ; Liver Neoplasms/*pathology ; Proto-Oncogene Proteins c-bcl-2/metabolism ; RNA, Messenger/metabolism ; Receptors, Tumor Necrosis Factor, Member 25/metabolism ; Receptors, Tumor Necrosis Factor, Type I/metabolism ; bcl-Associated Death Protein/metabolism

Identifying allergic sensitization is important for the proper diagnosis and management of allergic diseases. Skin prick testing and measuring serum specific IgE antibodies are standard tests to confirm allergic sensitization. Skin prick testing has many advantages, but it is difficult to perform on young children. Serum specific IgE can be easily performed on young children, but it can be performed only up to 12 antigens in patients younger than 6 years due to insurance coverage. Therefore, it is important to select appropriate antigens for the patients. Appropriate allergens may vary depending on the patient's age, accompanying disease, and residential area, so that detailed history taking is essential for proper allergen selection. In this review, we will discuss considerations for selecting appropriate allergens for clinicians when performing an allergy test on difficult-to-test children under 6 years of age.
Allergens ; Antibodies ; Asthma ; Child* ; Dermatitis, Atopic ; Diagnosis ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Insurance Coverage ; Rhinitis, Allergic ; Skin

No abstract available.
Myocardial Bridging* ; Sleep Apnea, Obstructive* ; Spine*

No abstract available.
Myocardial Bridging* ; Sleep Apnea, Obstructive* ; Spine*